After first signaling to Senate aides that the Senate-passed health care reform bill must be signed into law before Congress acts on companion reconciliation legislation, the Senate Parliamentarian has acknowledged that there are perhaps ways to draft a reconciliation measure that could move first.

However, it appears that if Democrats choose to pursue reconciliation before the Senate bill is enacted, they likely would have to narrow the scope of the reconciliation bill.

The Parliamentarian has indicated that attempting to move a comprehensive reconciliation package absent the $875 billion Senate-passed bill becoming law could create challenging procedural hurdles for Senate Democrats to overcome. Reconciliation bills operate under a narrow set of guidelines, and Senate Republicans are vowing to raise procedural objections over any portions of the legislation that they believe break the rules.

The Senate Parliamentarian's office this week informed the Senate GOP leadership that reconciliation instructions require any reconciliation bill to make changes in law. The Parliamentarian's office is standing by this advice, according to Senate aides.

House Democrats would rather hold off on sending the Senate-passed health care reform bill to the president's desk until after the Senate acts on the reconciliation package of adjustments and fixes to that bill. But the Parliamentarian's ruling from earlier this week suggests that Democrats would have an easier time passing the Senate bill first.

Additionally, changing the Senate-passed health care reform bill would be a simpler process than trying to rewrite the provisions of that legislation using a complicated alternative strategy that would involve amending already existing laws so as to supersede what is proposed in the underlying Senate bill.

However, it appears the Democrats might not face such procedural obstacles if they chose to slim down the reconciliation package and only make changes to current law. For example, if they chose to include only adjustments to things such as Medicare or Medicaid, they would probably be on solid ground, even if reconciliation cleared prior to Obama signing the underlying Senate bill.